维持性腹膜透析病人总Kt/V与腹主动脉钙化的关系

Relationship between the total Kt/V and abdominal aortic calcification in maintenance peritoneal dialysis patients

目的:探讨维持性腹膜透析病人总尿素清除指数(Kt/V)与腹主动脉钙化(AAC)的相关性。方法:选取于安徽医科大学第二附属医院腹膜透析中心规律随访并行腹部侧位X线片检查的腹膜透析病人111例。根据腹部侧位X线片是否存在AAC分为无钙化组54例和有钙化组57例。对2组病人的一般资料、实验室指标等临床相关资料及总Kt/V情况进行比较,并分析AAC发生的相关因素。结果:钙化组的年龄、透析龄、血磷及脑尿钠肽水平均明显高于无钙化组(P<0.05~P<0.01);而血红蛋白、总Kt/V、白蛋白、左心室射血分数均低于无钙化组(P<0.05~P<0.01)。Spearman多因素相关分析显示,年龄、透析龄、血磷、脑尿钠肽与AAC均呈正相关(P<0.05~P<0.01),血红蛋白、总Kt/V、白蛋白、左心室射血分数与AAC均呈负相关(P<0.05~P<0.01)。多因素logistic回归分析提示较高的年龄(OR=1.116,95%CI:1.066~1.169,P<0.01)、较低的血红蛋白(OR=0.966,95%CI:0.941~0.992,P<0.05)及总Kt/V下降(OR=0.362,95%CI:0.175~0.747,P<0.01)是AAC的危险因素。结论:腹膜透析病人总Kt/V是AAC的独立危险因素。

Objective:To explore the correlation between the total urea clearance index(Kt/V) and abdominal aortic calcification(AAC) in maintenance peritoneal dialysis(PD) patients.Methods:A total of 111 PD patients with regularly followed up in the Peritoneal Dialysis Center of the Second Affiliated Hospital of Anhui Medical University and lateral abdominal X-ray examination were investigated.According to the presence or absence of AAC on lateral abdominal radiographs,the patients were divided into the non-calcification group(54 cases) and calcification group(57 cases).The general data,laboratory indicators and total Kt/V between two groups were compared,and the related factors of AAC were analyzed.Results:The age,dialysis time,serum phosphorus and natriuretic peptide levels in calcification group were significantly higher than those in non-calcification group(P<0.05 to P<0.01).However,the hemoglobin level,total Kt/V,albumin level and left ventricular ejection fraction in calcification group were significantly lower than those in non-calcification group(P<0.05 to P<0.01).The results of Spearman multivariate correlation analysis showed that the age,dialysis time,serum phosphorus and cerebrouretic natriuretic peptide levels were positively correlated with AAC(P<0.05 to P<0.01),while the hemoglobin level,total Kt/V,albumin,left ventricular ejection fraction were negatively correlated with AAC(P<0.05 to P<0.01).The results of multivariate logistic regression analysis showed that the higher age(OR=1.116,95%CI:1.066-1.169,P<0.01),lower hemoglobin(OR=0.966,95%CI:0.941-0.992,P<0.05) and decrease of total Kt/V(OR=0.362,95%CI:0.175-0.747,P<0.01) were the risk factors of AAC.Conclusions:The total Kt/V in PD patients is the independent risk factor of AAC.